Optum Registration Forms

The system can automatically generate a form for Optum registration and show which items need completion. The person in charge of Intakes, or the Medical Records or Front Desk person needs to enter the proper information in the specific section of the client's file.

Client Demographics

Information on client name, social security number, date of birth, Address and phone numbers are auto-populated from the client's file, so it is important to complete the fields under the "Demographics" tab as completely as possible.

Diagnostic Categories at time of registration (all that apply): This information is under Extended Information on the ID tab.

Mental Health Diagnosis (no SMI/SED): This information is under Extended Information on the ID tab

SocioEconomics

Household Monthly Income: Calculates the income from the data loaded under each relationship, enter the info under the "Relationships" tab

Number of Dependents in Household: This portion, because being specific of the Optum form needs to be entered under the "Extended Information" on the "ID" tab

About the Consumer

Ethnicity, Race, Tribal Affiliation, Marital Status, and Primary Language are all available under the "Extended Information" on the "ID' tab

Legal Guardian

All the information for the legal guardian is inferred from the relationships. Make sure that the legal guardian person is loaded in the system and associated as a relationship to the client. Also make sure that under that relationship the "legal guardian" box is checked.

Emergency Contact

Same as legal guardian, the check box "emergency contact" under relationships defines this person.

PCP

Select a PCP by searching the PCP box on the "ID" tab. Once a PCP is selected, all the correspondent information will be loaded in the form.

Referral Information

Similar to ‘’’Extended Information’’’, if the client has an external referral, then it is loaded under the "ID" tab.

About Appointment

‘’’Intake Completion Date’’’ needs to be filled in the "extended information". ‘’’First Offered Appointment Date’’’ and ‘’’First Appointment Accepted’’’ are pre-populated from the system info.

About diagnosis

The current diagnosis on file for the Client will be displayed.

Miscellaneous

‘’’Living Arrangement’’’ and ‘’’Living Situation’’’ are available under "Extended Information". ‘’’WRAP’’’ and ‘’’Advance Directive’’’ are loaded with the defaults.

CYFD Information

All items are available under "Extended Information".

CYFD Family Member

This section pre-populates from "Relationships". If there is a person who is the CYFD family member, check the box ‘’’CYFD family member’’’ under the given relationship.